/enri-thumbnails/careeropportunities1f0caf1c-a12d-479c-be7c-3c04e085c617.tmb-mega-menu.jpg?Culture=en&sfvrsn=d7261e3b_1)
/cradle-thumbnails/research-capabilities1516d0ba63aa44f0b4ee77a8c05263b2.tmb-mega-menu.jpg?Culture=en&sfvrsn=1bc94f8_1)
7e6fdc03-9018-4d08-9a98-8a21acbc37ba.tmb-mega-menu.jpg?Culture=en&sfvrsn=7deaf618_1)
Students’ Take: Honing Critical Evaluation Skills via The Journal Club
The inception of the Internal Medicine Student Interest Group’s (IM SIG) Journal Club in 2023 stemmed from the recognition that while medical students understand and learn valuable skills to critically analyse scientific papers through courses like the Scientific Enquiry & Evidence based Medicine (SEEM) modules in Years 1 and 2, there are limited opportunities to apply these skills in student life.
Hence, the objective and focus of the Journal Club is to better understand established medical knowledge rather than learning how clinical guidelines are determined through research. Given the dynamic nature of Internal Medicine and the constant influx of new research, learning and understanding how medical research translates into clinical practice guidelines is essential for medical students.
“The IM SIG Journal Club aims to equip students with the ability to critically evaluate research papers, discerning the nuances between different studies and determining their applicability to clinical practice in our Singaporean context. With the prevalence of conflicting evidence in medical literature, the club seeks to instill a mindset of critical evaluation rather than blind acceptance of research findings,” said Prabanjini Rajkumar, an M4 student leader who organised the second IM SIG Journal Club in February 2024.
The second IM SIG Journal Club delved into the topic of Lecanemab in early Alzheimer’s disease. Lecenemab, a type of antibody, is currently being studied in people with early-stage Alzheimer's disease. This antibody targets and attaches strongly to certain proteins called Aβ soluble protofibrils. Clinical trials were conducted across multiple centres, with results showing significant improvement in amyloid burden, clinical dementia symptoms and independent activities of daily living. This led to Singapore recently ordering a batch of Lecenemab.
Key takeaways from the Journal Club presentation included the recognition that clinical significance extends beyond statistical significance, with considerations such as functional status of patients, accessibility, affordability, and risk of adverse effects playing pivotal roles.
Students learnt how to technically analyse papers using tools such as the Cochrane ROB-2 (version 2 of the Cochrane risk-of-bias tool for randomised trials) quality analysis and Centre for Evidence-Based Medicine (CEBM) Oxford tool, which leads to movement towards exact p-value reporting.
Additionally, a cautionary approach was advised by content experts regarding over-reliance on recognised Western medical centres, particularly considering controversial FDA approvals, and the recognition of variations in disease presentation across different populations and ethnic groups. FDA approval of a drug means that data on the drug’s effects have been reviewed and determined to provide benefits that outweigh its known and potential risks for the intended population.
Students are encouraged to come forward to participate in the Journal Club to enhance their academic presentation skills, stay updated on cutting-edge treatments and clinical practices, and engage with esteemed content experts from the various sub-specialties within Internal Medicine. IM SIG Journal Club is in the midst of planning its next Journal Club, and are looking to hold one that focuses on various other Internal Medicine sub-specialties.